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    Published On : Wed, Nov 12th, 2014

    Mass Murder or mass sterilization?

    sdfs

    Dr. Lata on left, Dr. Swati on center & Dr. Sanjay on right

    This happened in our neighboring state Chattisgarh – a state that is showcased as an ‘ideal model of development’ and where the incumbent BJP Government was just re elected less than an year ago.

    Four days ago, 83 women were herded like cattle, many of them against their will, to an abandoned, obviously unclean hospital, made to lie down on the floor next to each other and sterilized through the laproscopic method. Which is a peep hole surgery through their abdomen to ‘tie their tubes’

    so that they cannot conceive.

    The operated women were sent home immediately and told they could lead a normal life, just a small procedure had been carried out and there would be no complications. THEY WERE RIGHT, THERE WERE NO COMPLICATIONS – MANY WOMEN JUST DIED THE VERY DAY. ALL OTHERS ARE CRITICAL.

    ONCE YOU ARE DEAD, WHAT COMPLICATIONS CAN THERE BE?
    So what went so horribly wrong? According to reports coming in, there were no pre – tests done on the women. They are supposed to have their blood, urine samples checked for haemoglobin, infections and even the condition of their hearts has to be ascertained. Some of these women had diabetes, some suffered from severe anemia, some had asthama, some had heart problems and one or two had just delivered! There was no way they should have been having this operation.

    THE HOSPITAL
    Guidelines say such sterilization camps are to be conducted in “established health care facilities which are recognized by the government”. In this case a deserted private hospital that has been in disuse for some time in a village in Bilaspur District was used. One room of this building was used for all the surgeries.

    THE PROCEDURE
    A laproscope is used and through a minute slit in the abdomen the instrument reaches the woman’s fallopian tubes, that carries eggs from the ovary to her uterus, and they are ‘ligated’ or tied off. The USP of this procedure is that it is supposed to be ‘reversible’ – if the couple changes its mind and wants to have more issues later on, the tubes can be ‘untied’.

    Again, guidelines say that the laproscope must be scruplously sterilized after each operation and in no case more than ten surgeries carried out by the same instrument and by one Doctor. Also, it is prescribed that at one medical centre not more than THIRTY procedures should be done on a day.

    In this case, the same laproscope was allegedly used (without sterilization?) for ALL the operations that were carried out non stop by the same Doctor – Dr. R.K. Gupta. That is how he could achieve a ‘rate’ of one procedure in FOUR minutes. IT IS WORTH NOTING THAT THIS DOCTOR HAS BEEN FELICITATED RECENTLY BY THE CHATTISGARH C.M. RAMAN SINGH FOR HAVING CARRIED OUT 50,000 LAPROSCOPIC SURGERIES SO FAR.

    Such a veteran should have been well worsed in taking obvious precautions one would have thought or has he become so complacent and arrogant that he thinks as long as gets the ‘number’ everything else will take care of itself?

    THE PATIENTS
    Women on whom this procedure is to be carried out have to be tested prior to the surgery for Haemoglobin, infections and even their heart condition. They are to be kept under observation later and even if they are sent home soon, a home visit done to check on their condition. Obviously, both were not done.

    Shockingly, many of the women operated upon had diseases like asthama, diabetes, had low Hb and some had delivered very recently. NONE OF THEM SHOULD HAVE BEEN STERILIZED AT THIS CAMP.
    As this story is published, Dr. Gupta has still not been arrested and neither the state Health Minister nor the Central Health Minister are taking this issue seriously. Is it because it is poor tribal women living in some remote area of India that died and are suffering?

    WHAT ARE THE DOCTORS IN NAGPUR SAYING
    Nagpur Today spoke to two local Doctors, Gynecologists for their opinion – one from Lata Mangeshkar hospital and the other in the private sector running her own hospital.

    Dr. Lata Ajay Tapnikar who is Associate Professor at the Lata Mangeshkar hopital and is an MBBS, DGO, MD and PGDp in Antropology and Tribal Development EXPRESSES SHOCK AND OUTRAGE AT THIS HAPPENING.
    “We are given targets too and carry out such camps in our Hospital and also in hospices in tribal areas, but we take all precautions; NEVER HAVE WE LOST A SINGLE PATIENT IN SUCH A SURGERY.” Dr. Lata said emphatically.

    She opines that only utter neglect and flouting of all medical norms could have resulted in such a mishap.
    She is high praise for Government employed Doctors and Docs in Govt Medical College and Indira Gandhi (Mayo) hospital in Nagpur.

    “Their conditions might be dilapidated looking, they are flooded with patients, the staff and Doctors are over worked, but if if want to save a critical patient’s life there is no alternative to these two hospitals – and also a hospital like Lata Mangeshkar which is almost like a Govt. Hospital. We are very scruplous with patient care and taking all necessary precautions.”

    “It is where commercialization comes in that things start going wrong” is her opinion.
    Dr. Swati Barad – runs the Barad Hospital on Umred road along with her husband Dr. Pradeep Barad who is an orthopedic surgeon. She is also a Gynaecologist with an MBBS, DGO and MD.

    Whether minor or major, a surgery is a surgery and adequate precautions must be taken by the hospital. When a patient comes for surgery she puts her life in the hands of the Doctor with utmost confidence and faith, it is for the Doctor to live up to that faith” says Swati.

    She confides to NT that there is great pressure to carry out as many TL (Tube Litigation) procedures as one can to fulfill Family Planning goals and targets set by the Central Government.

    “So even we, in the private sector are encouraged to carry out such operations”. But unlike in surgery camps and some Govt hospitals Dr. Barad prefers to give her patients spinal/ general anaesthesia during the procedure rather local.

    “It is so the patient relaxes completely and is pain free” she clarifies. “Depending on the physical condition of the patient there can be different complications during the process itself and one has to be prepared for all of them. I ALWAYS FOLLOW A PROTOCOL AND MY PATIENTS FEEL 100% SAFE BECAUSE OF THEM”.

    Even other Nagpur Doctors, who are not Gynaecologists have been discussing this event with shock and outrage.
    “Very tragic and sad. Huge neglect has taken place. We are discussing the cause of this among ourselves. Even if sepsis ( blood poisoning) happens it takes 48 to 72 hours for the patient to succumb – if patients have died the same day we cannot even imagine what has caused it. We are suspecting there may be problem with I.V. drugs or medicines, since so many of them are in bad shape.The guilty must be punished severely” said Dr. Sanjay Marwah a renowned surgeon of Nagpur.

    ONE QUESTION THAT WE ALL – AND SPECIALLY THE GOVERNMENT HEALTH OFFICIALS NEED TO ASK THEMSELVES IS WHY IN INDIA ARE ONLY WOMEN TARGETED FOR FAMILY PLANNING OPERATIONS?

    The fact of the matter is that when a man is sterilized, the procedure is simpler, there is little or no loss of blood and he can really go back to normal life almost immediately. The financial incentive is also more in the case of a man – it is double as that for a woman!

    AND YET, FOR LAKHS OF WOMEN STERILIZED NATION WIDE THERE ARE JUST A FEW THOUSAND MEN SHO UNDERGO THE PROCEDURE.

    The ratio varies from state to state. In Chattisharh it is 19:1. In a medically advanced state, and that has good over all medical indicators the ratio is a shocking 165!
    Dr. Swati Barad says that more publicity should be given to male vasectomy.

    “Just like they publicize the ‘mother and child’ programs, talk about nutritional needs of pregnant women, they should educate Indians about how it is better for men to undergo these procedures. Failing this, the onus for family planning falls directly on the woman.” She says.

    But where a girl child is discriminated against right from the time she is conceived, what else can you expect in a country like ours?
    She is killed in the womb, she is ‘killed’ by malnourishment, she is killed in sexual abuse, she is killed for dowry and she is also killed for her ability to give birth.

    By Sunita Mudliyar

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